5 things we learned about Alzheimer’s disease in 2019
Each year brings advances in Alzheimer’s research — possible new drugs, new suggestions on how to keep your brain healthy, new discoveries that could crack open the complexity of this devastating disease.
But 2019 was a breakthrough year. The headlines were promising: Possible first-ever drug to reduce Alzheimer’s symptoms; Bill Gates donates $10 million to accelerate early clinical phases of drug development; new federal law brings the annual Alzheimer’s and dementia research funding at the National Institutes of Health (NIH) to $2.8 billion
Here are five of the most promising research advancements we learned about in 2019:
1. Biogen’s decision to seek approval from the U. S. Food and Drug Administration for the investigational drug, Aducanumab.
Dr. Kenneth Pugar, President and Founder of the Dayton Center for Neurological Disorders, said, “after a decade of disappointment, 2019 did bring with it some hope. At the top of the list is the potential for having the first FDA approved drug.”
Dr. Pugar said while it will not be a cure, the investigational drug Aducanumab could reduce the clinical decline of Alzheimer’s disease. Current drugs provide only symptomatic relief. “It’s the first one we ever had that could slow down the disease in patients with MCI or mild dementia,” Dr. Pugar said. The FDA could approve the drug, decline approval or ask for another study, Dr. Pugar said.
2. Adopting healthy lifestyle habits may counteract genetic risk for dementia.
Previous studies have pointed to the importance of healthy habits to help reduce the risk of dementia. Last year, a study indicated that adopting multiple habits could potentially slow the progression of the disease, even if you have a genetic risk.
Researchers are measuring how lifestyle interventions such as exercise, diet, cognitive engagement and health coaching affect biological markers of Alzheimer’s and dementia in the brain. “People have always asked before in the field of biomarkers why do you want to know if you are at risk because what can you do about it?” Dr. Pugar said. “Now we are learning that people can make lifestyle adjustments — like the heart-healthy diet, vigorous exercise, not smoking, moderate alcohol intake — that can potentially retard that progression.
3. A non-invasive, affordable and reliable test for Alzheimer’s disease may be on the way.
Alzheimer’s researchers are getting closer to developing lessinvasive methods, like a blood test, to determine if individuals have the biomarkers for cognitive decline and dementia. There is a great need for a simple, noninvasive and inexpensive diagnostic tool.
Currently, the only reliable way to assess brain changes that occur before Alzheimer’s dementia symptoms appear is through a (PET) scan, and by measuring beta-amyloid and tau proteins in spinal fluid. Those methods are expensive and, in the case of a spinal tap, invasive. Also, too often, they are not covered by insurance or are difficult to access.
A simple blood test could increase early detection and diagnosis, which allows individuals and families to have more time to plan for the future, increase their chances of participating in clinical trials, and get the care and support services they need.
4. Alzheimer’s risk and progression differs by gender.
At last year’s Alzheimer’s Association International Conference (AAIC), several studies were presented about the differences between women and men and their risk of developing Alzheimer’s. These new areas of research indicate that there may be other reasons — besides women living
longer — why two-thirds of people living with Alzheimer’s disease in the United States are women.
Dr. Pugar said, “Since I was a resident 30 years ago, we recognized and saw dementia more in women than in men. The thought was that women live longer… the life expectancy between women and men is narrowing,” Dr. Pugar said. “The question is are women’s brains more predisposed to the disease.”
5. New targets — other than beta-amyloid and tau — are being explored
A significant challenge to better treating and preventing Alzheimer’s is that researchers don’t know exactly what causes Alzheimer’s disease.
The buildup of two proteins, called beta-amyloid and tau, are seen as damaging and killing nerve cells in Alzheimer’s disease. For years, researchers focused on those two proteins.
Now researchers are looking at other targets — like inflammation and glucose metabolism — as possible new causes. Dr. Pugar compared it to cancer treatment. “The best cancer therapies aren’t just one drug. We attack it from several different pathways.” Dr. Pugar hopes it doesn’t stop there. “We also need work on the symptomatic side – how can we help with day/ night sleep cycle problems, how can we help with aggression, delusions and patients not wanting to eat,” Dr. Pugar said. “That’s what I deal with, an exhausted caregiver who is up all night because their spouse is calling the police, trying to leave or roaming in the house.”